Credentialing and contracting are essential components of healthcare operations. Credentialing is the process of verifying the qualifications and professional background of healthcare providers, while contracting involves establishing agreements between healthcare providers and payers to ensure payment for services rendered. These processes are crucial for ensuring that healthcare providers deliver high-quality services and receive fair compensation […]
contracting, Credentialing, Credentialing and Contracting, Credentialing and Contracting Checklist, healthcare credentialing, medical credentialing, Payer Contract, Payer ContractingThe process of medical credentialing is crucial in ensuring the quality and safety of healthcare services. It involves verifying the credentials and qualifications of healthcare providers and evaluating their competency to provide medical services. We’ll examine the importance of proper medical credentialing and how it benefits both healthcare providers and patients. What is Medical Credentialing? […]
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The Process and Importance of Medical Credentialing What is Medical Credentialing? Medical credentialing is a vital process for ensuring the quality of healthcare services. It involves verifying the education, training, and professional experience of healthcare providers to ensure that they meet the standards for practicing in their field. This process helps to ensure that patients […]
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As a healthcare provider, your goal is to help people. However, this type of work is unsure at times. If a healthcare worker makes a misstep, they could harm a person’s health. Even if there hasn’t been any maltreatment or mistake on the part of the healthcare practitioner, disagreements can result when physicians’ and patients’ […]
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Social Media and Patient Privacy in Healthcare A Few Use Cases Use Case #1: Use Case #2: Protected Health Information (PHI) Preserving privacy of patients’ protected health information (PHI) is one of the major concerns linked to social media in healthcare. Privacy and protection of such information are dealt with in federal law and overseen […]
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Bringing new providers aboard is invigorating, yet a complex process with plenty of moving parts. If you’ve ever had the opportunity to hire a physician or mid-level professional, you know just how much work is involved. Payer enrollment is maybe one of the more essential, yet misunderstood pieces of the puzzle. No doubt, making your […]
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Medical Practice Management Challenges Solved by Outsourced Medical Billing Quality, Outsourced Medical Billing is the Answer The billing team at Capitol Healthcare practice had been reaching a high bar of excellence. But that bar was endangered when long-time staff members began to retire. “Some of the staff had been here for a long time, like […]
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Common Revenue Cycle Management Mistakes Is Your Revenue Cycle Management in Top-Notch Condition? Let’s face it, we all make mistakes, even as veterans in revenue cycle management. Sometimes, though, our biggest mistakes are the ones right under our noses – the ones we simply don’t identify as mistakes because we’ve been making them for so […]
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Medical Billing and Credentialing Made Easy “There just has to be an easier way to perform our billing and credentialing.” Does any of this sound familiar? I’m tired of dealing with insurance companies! I got into healthcare because I wanted to focus on patients, not paperwork and red tape! I’d rather do without having to […]
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Health Insurers and Prior Authorization Like sands through the hourglass, so are the days of prior authorization “This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools […]
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Medical Credentialing is Crucial for Healthcare Providers; Here’s Why Truth is, many patients know little more about their physician’s qualifications than what they see neatly hanging from their office wall. While they’re able to access in-depth background information about their auto mechanic, it’s when they are at their most vulnerable, entrusting their family’s health to […]
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Outsource Your Medical Billing to Avoid Issues Installing a cost-effective, effectual medical billing team is one of the biggest challenges for any healthcare provider. Whether you’re a behavioral health provider, genetic testing lab or a substance abuse facility, it isn’t easy to create, maintain and scale your own internal medical billing team. Below, some of […]
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Choose a Qualified Medical Billing Group Since there are a large number of companies offering medical billing services, it’s often difficult for a healthcare provider to choose the best-fit, third party billing group for their organization. Healthcare providers have to ask billing companies the right questions on systems and services rendered, thereby making it much […]
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What is Medical Billing? Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a healthcare provider. It involves coding and classification of diseases, procedures, and treatments and submission of claims to insurance companies for reimbursement. The goal of medical billing is […]
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Which Medical Credentialing Processes Distinguish Medwave from our Competitors? There are a number of points which separate us from our competition, both on the medical billing and credentialing side, but specifically for credentialing. Contact us today and we’ll efficiently credentialing your medical group, getting you in-network with both private and public payor / insurance companies. […]
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Medical Credentialing On-Boarding Medical Credentialing Credentialing for healthcare providers, hospital groups and facilities is a tedious task that often requires a team of specialists to handle all the on-boarding information, as well as updates throughout the year. As of April, 2018, CMS now mandates that providers maintain accurate information and timely updates. Providers and facilities that […]
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Medical Billing and Credentialing Differences Medical billing and credentialing for medical providers are two different categories in the healthcare world. Before any medical billing can even be completed, the healthcare provider needs to be credentialed with insurance companies in order to be an approved provider of services. Becoming credentialed as an in-network provider dictates the […]
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Medical Provider Resources Information for medical providers, including links to NPI, CAQH and ICD-10 resources. Medicare: https://www.novitas-solutions.com NPI Registry portal: https://npiregistry.cms.hhs.gov CAQH provider portal: https://www.caqh.org Free ICD-10 lookup tool: https://www.icd10data.com Navinet Provider portal: https://navinet.navimedix.com 2017-2018 CDC Flu Vaccine Information: https://www.cdc.gov/flu/about/season/flu-season.htm Follow my blog with Bloglovin
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